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EL�CTRICAL PERMIT �4PPLICATION <br />CITV OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �p �- /� "/� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org C � a10-- � a3 <br />,��s 5� �✓�h� <br />PROJECTADDRESS <br />57/�R�3v'c;�S <br />Owner <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� jl��}GC Il�i� r� ��C� ( � �Fl �b'�U�' <br />Mail Address <br />S�R���i3�cKs <br />Te�anl Mail Address <br />Elect�icalContracto� � MailAddress <br />��o✓� �R�ts'��N`l <br />Slale License Number <br />Proposed Use af Building <br />Square Foo�age (If residential new construction, remodel or addition) <br />Description of Work l0 8e Done: /N`'1 ��� l'U(r N,�C'v <br />�7 � L L!% . G'S/�'v" �/C /S//N(r G_/��C tJIT <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />CITY OF EVERETI' LOCAL SALES TAX CODE IS 3105 <br />1 here6y certi(y that 1 have read and examined this applicafion and <br />conect. /�II prowsions o/laws and ordinances goveming this type <br />whetherspecilied herem ornot. The granting of a permit does nof <br />violateorcancelthe provisionso(anyotherstafeorlocallawregu <br />pedormance o/construcfion. That 1 am authonzed by the owneroi <br />work for which application is made and I comply with the State Cor <br />296.200 WAC. <br />i/ <br />City <br />City <br />City <br />State/Zip <br />Stale/Zip <br />v�c C' �- ' <br />State/Zip <br />Phane <br />Phone <br />'l y= S�fi-- .23 <br />Phone <br />��Do _ <br />Coniract Price of Work <br />�'�/�rJt�/<OZdN 'v2�� -75J -3{/so <br />Contact Person (Plan Review) <br />7/-' Y� /?� � 1z/(7�E�/'/� % E� C'ii 5� /f' O�/� �,E <br />FEE <br />etobefrueand � �2(.i�' �2.� <br />complefed <br />✓e aufhonty to <br />tion or the <br />b per(orm tho <br />'8.27 RCW and <br />�p.—j7- j�— <br />